Is there evidence to support the need for routine surgeon presence on trauma patient arrival?

Annals of Emergency Medicine
Steven M Green

Abstract

The trauma center certification requirements of the American College of Surgeons include the expectation that, whenever possible, general surgeons be routinely present at the emergency department arrival of seriously injured patients. The 2 historical factors that originally prompted this requirement, frequent exploratory laparotomies and emergency physicians without trauma training, no longer exist in most modern trauma centers. Research from multiple centers and in multiple varying formats has not identified improvement in patient-oriented outcomes from early surgeon involvement. Surgeons are not routinely present during the resuscitative phase of Canadian and European trauma care, with no demonstrated or perceived decrease in the quality of care. American trauma surgeons themselves do not consistently believe that their use in this capacity is either necessary or an efficient distribution of resources. There is not compelling evidence to support the assumption that trauma outcomes are improved by the routine presence of surgeons on patient arrival. Research is necessary to clarify which trauma patients require either emergency or urgent unique expertise of a general surgeon during the initial phase of trauma management. Indi...Continue Reading

References

Aug 1, 1992·The Journal of Trauma·R SinghP Lane
Jan 1, 1992·Annals of Internal Medicine·A D Oxman, G H Guyatt
Mar 1, 1992·The Journal of Trauma·C T ThompsonJ C Sacra
Apr 1, 1992·The Journal of Trauma·E E MooreF A Moore
Feb 1, 1992·The Journal of Trauma·J D Richardson, F B Miller
Apr 1, 1994·Annals of Emergency Medicine·F G DeKeyserA Trask
Jan 1, 1993·The Journal of Trauma·J A Phillips, T G Buchman
Mar 1, 1996·Annals of Emergency Medicine·E H GilbertJ Steiner
Mar 1, 1997·The Journal of Trauma·F HulkaD D Trunkey
Oct 17, 1998·Annals of Emergency Medicine·B R PlaisierM A Malangoni
Jan 27, 2000·The Journal of Trauma·J D Richardson
Oct 4, 2000·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·M D DowdR M Ruddy
May 24, 2001·The Journal of Trauma·L S EastesR J Mullins
Jul 4, 2001·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·E B Lerner, R M Moscati
Apr 23, 2003·The Journal of Trauma·J David Richardson, Frank B Miller
Jun 5, 2003·The Journal of Trauma·Ronald V Maier
Jun 11, 2003·Annals of Surgery·Joseph J TepasCarla DiScala
May 20, 2004·Journal of the Royal Army Medical Corps
Jun 3, 2004·Lancet·Avery B NathensRonald V Maier
Jul 3, 2004·Pediatric Emergency Care·Li Ern ChenRobert P Foglia
Mar 12, 2005·The Journal of Trauma·Henry M Cryer
Mar 12, 2005·The Journal of Trauma·UNKNOWN Committee to Develop the Reorganized Specialty of Trauma, Surgical Critical Care, and Emergency Surgery
Apr 13, 2005·The Journal of Trauma·David J CieslaJon M Burch
Jun 1, 2005·Journal of the American College of Surgeons·Walter L BifflWilliam G Cioffi
Aug 13, 2005·The Journal of Trauma·Jorge L RodriguezJ David Richardson
Jul 1, 2005·Indian Journal of Clinical Biochemistry : IJCB·A S Kanagasabapathy, Pragna Rao

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Citations

Dec 13, 2007·The Journal of Trauma·Young-Ju KimSharyn D Gardner
Jun 11, 2011·Annals of Emergency Medicine·Steven M Green
Jun 11, 2011·Annals of Emergency Medicine·Jason S HaukoosErnest E Moore
Mar 11, 2009·The Journal of Emergency Medicine·Paul A WilletteMichelle L Wright
Apr 29, 2008·Annals of Emergency Medicine·Steven M Green
Feb 20, 2008·Annals of Emergency Medicine·Jennifer M AhmedDavid A Petrie
Feb 20, 2008·Annals of Emergency Medicine·Steven M Green, Robert Steele
Sep 11, 2007·Emergency Medicine Clinics of North America·Vincent J Markovchick, Ernest E Moore
Jan 2, 2007·Annals of Emergency Medicine·Jon Marinaro
Nov 23, 2006·Annals of Emergency Medicine·Jennifer M AhmedDavid A Petrie
Apr 25, 2006·Annals of Emergency Medicine·Ernest E Moore
May 18, 2013·Journal of Trauma Management & Outcomes·Diane L S HuntRuth Wetta
Jul 26, 2011·International Journal of Emergency Medicine·C James HollimanKathleen Clem

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